The prevalence rate of incisional hernia is 3% to 20% after 2 million laparotomies performed in the United States. Problematic factors related to development of incisional hernia include wound infection, immunosuppression, morbid obesity, previous operations, prostatism, and abdominal aneuvrysectomy.
Many ventral and parastomal hernia repair techniques have been described. Traditional primary repair involves a laparotomy with muscle or aponeurotic splitting incisions as preferred procedure to preserve the nerve and blood supply thus avoiding division of fibers, enhancing the approximation of edges of the wound when tension is increased. For these reasons transverse incisions, as shown in FIG. 1, were preferred to vertical incisions, as shown in FIG. 2. Increased intra-abdominal pressure approximate the fibers and close the defect. Closure of the wound was performed with strong non absorbable sutures. However, wide areas of soft tissue dissection increases bleeding during surgery as well as wound infection and related wound complications (12% and more).
These inherent complications have increased the interest in developing new surgical techniques for repairing the ventral and parastomal hernias without large subcutaneous raising/dissecting flaps and without bilateral fascial incisions of traditional hernia repair.